Murkin Townhomes.pdfCity of Edmonds
Land Use Application
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ARCHITECTURAL DESIGN REVIEW
COMPREHENSIVE PLAN AMENDMENT
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CONDITIONAL USE PERMIT
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HOME OCCUPATION
DATE
FORMAL SUBDIVISION
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SHORT SUBDIVISION
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LOT LINE ADJUSTMENT
HEARING DATE
PLANNED RESIDENTIAL DEVELOPMENT
OFFICIAL STREET MAP AMENDMENT
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STREET VACATION
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SHORELINE PERMIT
VARIAN""CT,/REASONABLE USE i'N(111-t1'I ON
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• PLEASE NOTE THAT ALL INFORMATION CONTAINED WITHIN THE APPLICATION IS A PUBLIC RECORD a
PROPERTY ADDRESS OR LOCATIONI— 011 y —1 Lpl" ATV -e W
PROJECT NAME (IF APPLICABLE)
APPLICABLE)0/ VY K1 A OW h V'OYV1{-&
PROPERTY OWNER. Lisa Hotta PHONE# I47IC5ry„wµµ1
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DESCRIBE HOW THE PROJECT MEET'S APPLICABLE CODES (ATTACH COVER LETTER AS NECESSARY), ,,,,,,,,_
APPLICANT
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CONTACT PERSON/AGENT ^Jmy�%Pt y �1 9ttJwl?i:#
ADDRESS
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The undersigned applicant, and his/her/its heirs, and assigns, in consideration on the processing of the application agrees to
release, indemnify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable attorney's
fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or incomplete information
furnished by the applicant, his/her/its agents or employees,.
By my signature, I certify that the information and exhibits herewith submitted are true and correct to the best of my knowledge
and that I am authorized to file this application on the behalf of the owner as listed below.
SIGNATURE OF APPI...:If" ANT
Property Owner's Authorization
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I, certify under the penalty of perjury under the laws of the State of
Washington that the following is a true and correct statement: I have authorized the above Applicant/Agent to apply for the
subject land use application, and grant my permission for the public officials and the staff of the City of Edmonds to enter the
subject property for the purposes of inspection and posting attendant to this application,
SIGNATURE OF OWNER DATE
Questions? Call (425) 771-0220,
Revised on 8/22//2 B - Land Use Application Page I of I
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) 2016
HOW
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MAR 10 2016
DEVELOPMENT SERVICES